Conculsion and summary

MSK podiatry services can make a significant difference to patient care and outcomes when the foot and lower limb are affected. The services can be accessed at every level of NHS delivery and vary in their provision of care. The following model is recommended for service provision, with each region having a model where the patient can be assessed at initial contact and given suitable advice or referral on to correct podiatry service, either community or MDT. This can be with a FCP in place, or a triage service provided by the GP as seen in the Bradford case study.







Within the podiatry MSK provision, there should be an advanced practitioner for each of the three specialities, Paediatrics, orthopaedic medicine (general MSK) and rheumatology. Each one of these lead a team of practitioners who provide care for that patient group. Each specialism should have access to the relevant diagnostic equipment and have appropriate skills for the group they serve. A range of relevant interventions should be available for the team to work with, and these can be audited with appropriate tools including PASCOM. At all levels, referral pathways to more advanced clinicians and other services should be available for the patient.

 

Specialties

Diagnostic

 

Intervention

Audit outcomes

Referrals

(Relevant to each patient group being treated)

Paediatric

Band 7 with PG training in paediatric

Imaging

 

Clinical testing

 

Gait analysis

 

Biomechanical assessment

 

Orthoses

Shockwave

Injection

Exercise prescription

Mobilisation

Taping

Acupuncture

Footwear advice

Gait retraining

Social prescribing

Orthodigital splinting

Advice

Appropriate outcome measure

 

PASCOM

Physiotherapy

Orthotist

Prescription Footwear

Surgery (orthopaedics or podiatric)

Interventional radiology

Phlebotomy

Rheumatology

Orthopaedic

Band 7 with PG training in relevant orthopaedic biomechanics

Rheumatology

Band 7 with PG training in Rheumatology


*PG=post graduate

Notes:

12  Musculoskeletal First Contact Practitioner https://www.hee.nhs.uk/our-work/musculoskeletal-msk-first-contact-practitioners


 

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